Estimación del coste de almacenamiento de una solución de preservación de la privacidad en archivos BAM reales

A menudo los científicos secuencian el ADN de un gran número de personas con el objetivo de determinar qué genes se asocian con determinadas enfermedades. Esto permite meóon del genoma humano. El precio de un perfil genómico completo se ha posicionado por debajo de los 200 dólares y este servicio lo ofrecen muchas compañías, la mayor parte localizadas en EEUU. Como consecuencia, en unos pocos a~nos la mayoría de las personas procedentes de los países desarrollados tendrán los medios para tener su ADN secuenciado. Alrededor del 0.5% del ADN de cada persona (que corresponde a varios millones de nucleótidos) es diferente del genoma de referencia debido a variaciones genéticas. Así que el genoma contiene información altamente sensible y personal y representa la identidad biológica óon sobre el entorno o estilo de vida de uno (a menudo facilmente obtenible de las redes sociales), sería posible inferir el fenotipo del individuo. Multiples GWAS (Genome Wide Association Studies) realizados en los últimos a~nos muestran que la susceptibilidad de un paciente a tener una enfermedad en particular, como el Alzheimer, cáncer o esquizofrenia, puede ser predicha parcialmente a partir de conjuntos de sus SNP (Single Nucleotide Polimorphism). Estos resultados pueden ser usados para medicina genómica personalizada (facilitando los tratamientos preventivos y diagnósticos), tests de paternidad genéticos y tests de compatibilidad genética para averiguar a qué enfermedades pueden ser susceptibles los descendientes. Estos son algunos de los beneficios que podemos obtener usando la información genética, pero si esta información no es protegida puede ser usada para investigaciones criminales y por compañías aseguradoras. Este hecho podría llevar a discriminaci ón genética. Por lo que podemos concluir que la privacidad genómica es fundamental por el hecho de que contiene información sobre nuestra herencia étnica, nuestra predisposición a múltiples condiciones físicas y mentales, al igual que otras características fenotópicas, ancestros, hermanos y progenitores, pues los genomas de cualquier par de individuos relacionados son idénticos al 99.9%, contrastando con el 99.5% de dos personas aleatorias. La legislación actual no proporciona suficiente información técnica sobre como almacenar y procesar de forma segura los genomas digitalizados, por lo tanto, es necesaria una legislación mas restrictiva ---ABSTRACT---Scientists typically sequence DNA from large numbers of people in order to determine genes associated with particular diseases. This allows to improve the modern healthcare and to provide a better understanding of the human genome. The price of a complete genome profile has plummeted below $200 and this service is ofered by a number of companies, most of them located in the USA. Therefore, in a few years, most individuals in developed countries will have the means of having their genomes sequenced. Around 0.5% of each person's DNA (which corresponds to several millions of nucleotides) is diferent from the reference genome, owing to genetic variations. Thus, the genome contains highly personal and sensitive information, and it represents our ultimate biological identity. By combining genomic data with information about one's environment or lifestyle (often easily obtainable from social networks), could make it possible to infer the individual's phenotype. Multiple Genome Wide Association Studies (GWAS) performed in recent years have shown that a patient's susceptibility to particular diseases, such as Alzheimer's, cancer, or schizophrenia, can be partially predicted from sets of his SNPs. This results can be used for personalized genomic medicine (facilitating preventive treatment and diagnosis), genetic paternity tests, ancestry and genealogical testing, and genetic compatibility tests in order to have knowledge about which deseases would the descendant be susceptible to. These are some of the betefts we can obtain using genoma information, but if this information is not protected it can be used for criminal investigations and insurance purposes. Such issues could lead to genetic discrimination. So we can conclude that genomic privacy is fundamental due to the fact that genome contains information about our ethnic heritage, predisposition to numerous physical and mental health conditions, as well as other phenotypic traits, and ancestors, siblings, and progeny, since genomes of any two closely related individuals are 99.9% identical, in contrast with 99.5%, for two random people. The current legislation does not ofer suficient technical information about safe and secure ways of storing and processing digitized genomes, therefore, there is need for more restrictive legislation.

Evolution and treatment of vitamin B12 deficiency as a risk factor for (cognitive and functional) neurodegenerative diseases in institutionalized elderly = Evolución y tratamiento de la deficiencia de vitamina B12 como factor de riesgo de enfermedades neurodegenerativas (cognitivas y funcionales) en las personas mayores institucionalizadas.

Prevalence of vitamin B12 deficiency is very common in elderly people and can reach values as high as 40.5% of the population. It can be the result of the interaction among several factors. Vitamin B12 deficiencies have been associated with neurological, cognitive deterioration, haematological abnormalities and cardiovascular diseases that have an important influence on the health of the elderly and their quality of life. It is necessary to approach the problems arisen from the lack of data relative to them. The main objective of this thesis was to analyse the evolution of vitamin B12 status and related parameters, lipid and haematological profiles and their relationship to health risk factors, and to functional and cognitive status over one year and to determine the effect of an oral supplementation of 500 μg of cyanocobalamin for a short period of 28 days. An additional objective was to analyze the possible effects of medicine intakes on vitamin B status. Three studies were performed: a) a one year longitudinal follow-up with four measure points; b) an intervention study providing an oral liquid supplement of 500 μg of cyanocobalamin for a 28 days period; and c) analysis of the possible effect of medication intake on vitamin B status using the ATC classification of medicines. The participants for these studies were recruited from nursing homes for the elderly in the Region of Madrid. Sixty elders (mean age 84 _ 7y, 19 men and 41 women) were recruited for Study I and 64 elders (mean age 82 _ 7y, 24 men and 40 women) for Study II. For Study III, baseline data from the initially recruited participants of the first two studies were used. An informed consent was obtained from all participants or their mentors. The studies were approved by the Ethical Committee of the University of Granada. Blood samples were obtained at each examination date and were analyzed for serum cobalamin, holoTC, serum and RBC folate and total homocysteine according to laboratory standard procedures. The haematological parameters analyzed were haematocrit, haemoglobin and MCV. For the lipid profile TG, total cholesterol, LDL- and HDLcholesterol were analyzed. Anthropometric measures (BMI, skinfolds [triceps and subscapular], waist girth and waist to hip ratio), functional tests (hand grip, arm and leg strength tests, static balance) and MMSE were obtained or administered by trained personal. The vitamin B12 supplement of Study II was administered with breakfast and the medication intake was taken from the residents’ anamnesis. Data were analyzed by parametric and non-parametric statistics depending on the obtained data. Comparisons were done using the appropriate ANOVAs or non-parametric tests. Pearsons’ partial correlations with the variable “time” as control were used to define the association of the analyzed parameters. XIII The results showed that: A) Over one year, in relationship to vitamin B status, serum cobalamin decreased, serum folate and mean corpuscular volumen increased significantly and total homocysteine concentrations were stable. Regarding blood lipid profile, triglycerides increased and HDL-cholesterol decreased significantly. Regarding selected anthropometric measurements, waist circumference increased significantly. No significant changes were observed for the rest of parameters. B) Prevalence of hyperhomocysteinemia was high in the elderly studied, ranging from 60% to 90 % over the year depending on the cut-off used for the classification. LDL-cholesterol values were high, especially among women, and showed a tendency to increase over the year. Results of the balance test showed a deficiency and a tendency to decrease; this indicates that the population studied is at high risk for falls. Lower extremity muscular function was deficient and showed a tendency to decrease. A highly significant relationship was observed between the skinfold of the triceps and blood lipid profile. C) Low cobalamin concentrations correlated significantly with low MMSE scores in the elderly studied. No correlations were observed between vitamin B12 status and functional parameters. D) Regarding vitamin B12 status, holo-transcobalamin seems to be more sensitive for diagnosis; 5-10% of the elderly had a deficiency using serum cobalamin as a criterion, and 45-52% had a deficiency when using serum holotranscobalamin as a criterion. E) 500 μg of cyanocobalamin administered orally during 28 days significantly improved vitamin B12 status and significantly decreased total homocysteine concentrations in institutionalized elderly. No effect of the intervention was observed on functional and cognitive parameters. F) The relative change (%) of improvement of vitamin B12 status was higher when using serum holo-transcobalamin as a criterion than serum cobalamin. G) Antiaenemic drug intake normalized cobalamin, urologic drugs and corticosteroids serum folate, and psychoanaleptics holo-transcobalamin levels. Drugs treating pulmonary obstruction increased total homocysteine concentration significantly. H) The daily mean drug intake was 5.1. Fiftynine percent of the elderly took medication belonging to 5 or more different ATC groups. The most prevalent were psycholeptic (53%), antiacid (53%) and antithrombotic (47%) drugs.

Diagnosis and Management of Grain-Induced Asthma

Grain-induced asthma is a frequent occupational allergic disease mainly caused by inhalation of cereal flour or powder. The main professions affected are bakers, confectioners, pastry factory workers, millers, farmers, and cereal handlers. This disorder is usually due to an IgE-mediated allergic response to inhalation of cereal flour proteins. The major causative allergens of grain-related asthma are proteins derived from wheat, rye and barley flour, although baking additives, such as fungal α-amylase are also important. This review deals with the current diagnosis and treatment of grain-induced asthma, emphasizing the role of cereal allergens as molecular tools to enhance diagnosis and management of this disorder. Asthma-like symptoms caused by endotoxin exposure among grain workers are beyond the scope of this review. Progress is being made in the characterization of grain and bakery allergens, particularly cereal-derived allergens, as well as in the standardization of allergy tests. Salt-soluble proteins (albumins plus globulins), particularly members of the α-amylase/trypsin inhibitor family, thioredoxins, peroxidase, lipid transfer protein and other soluble enzymes show the strongest IgE reactivities in wheat flour. In addition, prolamins (not extractable by salt solutions) have also been claimed as potential allergens. However, the large variability of IgE-binding patterns of cereal proteins among patients with grain-induced asthma, together with the great differences in the concentrations of potential allergens observed in commercial cereal extracts used for diagnosis, highlight the necessity to standardize and improve the diagnostic tools. Removal from exposure to the offending agents is the cornerstone of the management of grain-induced asthma. The availability of purified allergens should be very helpful for a more refined diagnosis, and new immunomodulatory treatments, including allergen immunotherapy and biological drugs, should aid in the management of patients with this disorder.

Challenges for Allergy Diagnosis in Regions with Complex Pollen Exposures

Over the past few decades, significant scientific progress has influenced clinical allergy practice. The biological standardization of extracts was followed by the massive identification and characterization of new allergens and their progressive use as diagnostic tools including allergen micro arrays that facilitate the simultaneous testing of more than 100 allergen components. Specific diagnosis is the basis of allergy practice and is always aiming to select the best therapeutic or avoidance intervention. As a consequence, redundant or irrelevant information might be adding unnecessary cost and complexity to daily clinical practice. A rational use of the different diagnostic alternatives would allow a significant improvement in the diagnosis and treatment of allergic patients, especially for those residing in complex pollen exposure areas.